Sunday, November 18, 2018

Sonoma Medicine

The magazine of the Sonoma County Medical Association

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CURRENT BOOKS
Chewing the Fat

Jeff Sugarman, MD

Gulp: Adventures on the Alimentary Canal, Mary Roach, Norton, 352 pages (2013).

Gulp, the new book by science writer/humorist Mary Roach, offers an entertaining if somewhat meandering and tangential tour of the alimentary canal. From top to bottom Roach takes us to places we never knew existed, and she digs down deeply into the often odd and esoteric research of those committed to exploring where no one has wanted to go before.

Roach reminds us that taste is all about smell, especially if you are a dog. As a dog owner, I found her expose of the Palatability Assessment Resource Center (PARC), a pet food tasting research center, fun and interesting. She opens a strange and charming window into the life of a professional pet food taster. Who knew that if a pet food manufacturer wants to make a claim that dogs prefer brand X of kibble, the manufacturer must actually get data to support their claims at a lab like PARC?

Roach’s exploration of the science of saliva is quite entertaining as well. I was startled at the strangeness of some of the scientific projects she describes. For example, how does salivary breakdown of starch enhance flavor? Subjects in one study had to rate the taste of custard samples. Sounds like a great study to volunteer for, right? What the subjects did not know was that a drop of saliva was secretly added to their meal. Roach does not go into detail as to how the saliva samples were actually obtained.

The indefatigable Roach amasses so many fun facts that weaving them together into any kind of coherent story at times proves too difficult. The transitions from fact to factoid are often forced and create a zigzagging story line that dilutes from the theme she is attempting to illustrate. Her extensive footnoting, which in places seems to take up nearly as much text as the main body of the book, allows her to weave even more tangents into her story. They are often more entertaining than the stories in the main text.

The historical vignettes that provide the backdrop to our knowledge of certain digestive processes are quite compelling. In pursuing the digestive properties of the stomach, Roach explores the relationship between Alexis St. Martin, a trapper who was accidentally shot, leaving him with a fistula between his stomach and his skin, and William Beaumont, a researcher who experimented on St. Martin for several decades. The reader may forgive Roach for describing their relationship as “acid” because the interplay between these two and the resulting digestion experiments are so entertaining.

Starting with Moby Dick, Roach spends many pages on the historical pseudoscientific studies regarding the survivability of being eaten alive. “Would a man in a whale forestomach be crushed or merely tumbled?” she asks. The whole discussion seems ridiculous, but she does include some interesting research, including the work of 18th-century French naturalist Rene Reaumur, who studied raptor gizzard pressures using a small tube carrying meat.

My 15-year-old son would probably enjoy the sections describing the curiosities of the rectum. Here, Roach footnotes the work on gastrointestinal gas by Drs. Terdiman and Fardy. Similarly, the section on flatulence research would provide Daniel Tosh plenty of fuel for his stand-up jokes on “Tosh.0.” Of course Roach also can’t resist the stories of objects found by emergency department physicians that are stuck or lost in the anus.

Roach is also strangely attracted to macabre events, which she describes and embellishes with pithy details. In her section on the compliance of the stomach, she describes a woman whose stomach ruptured from overeating and the man who ate 18 pounds of cow brains. There is much to be learned here, although most of it may be utterly useless.

On the back cover, the book carries the label “science,” which is true in the loosest sense only. Gulp is not a serious book, notwithstanding the extensive referencing. However, how interesting could the alimentary canal really be to the lay reader? Roach cleverly solves this problem with humor, effectively holding our interest in areas that are often off limits. She approaches the very end of the alimentary canal, for example, by relaying interviews with prison inmates about the details of smuggling cell phones in their rectums. I can imagine Roach laughing to herself as she wrote this, and for that matter every page in this book, from the origins of fire-breathing dragons to the Bristol stool chart (complete with diagram).

Dr. Sugarman, a Santa Rosa dermatologist, serves on the SCMA Editorial Board.

Email: pediderm@yahoo.com


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